The aim of this analysis was to re-examine the classical concept of distal interphalangeal joint (DIP) psoriatic arthritis (PsA) as an entheseal-driven disease. Two cadaveric fingers with severe psoriatic arthritis were analyzed. Our results demonstrate that inflammation of DIP PsA is multifocal without interconnection between entheses and articular cartilage of the DIP. We found a clear association between synovitis and focal loss of articular cartilage at the head of the intermediate phalanx. https://www.selleckchem.com/products/diabzi-sting-agonist-compound-3.html By contrast, the articular cartilage adjacent to the zone of severe enthesitis did not show notable damage. Fibrocartilaginous destructions of enthesis were characterized by either a multifocal lymphocytic inflammation, accompanied by osteoclastic resorption, beginning on the interface between the uncalcified and calcified fibrocartilage and then extending into the bone or a subchondral bone inflammation which insidiously destroyed first the bone and then the fibrocartilage. Some sections well showed an inflammation (2) the thick ventral plate and to a lesser extend the thin dorsal plate constitute a barrier between the inflamed entheses and the articular cartilage, and (3) an unusual form of minute vascular foramen contributes to the early stage of enthesitis. This small study suggests that DIP PsA is a complex disease. It affects anatomical micro sites which, although close, are in fact relatively independent of each other. Further studies are needed to test this hypothesis.Xanthomas present clinically as eruptive, tuberoeruptive, tuberous, tendinous, or planar forms. Among these, eruptive xanthoma (EX) is characterized by sudden development of multiple, red-to-yellow papules, each less than 5 mm in diameter, on the extensor surface of the extremities and the buttock area. EX is often associated with severe hypertriglyceridemia, underlying diabetes, obesity, or excessive alcohol intake. Histologically EX is characterized by foamy cells, which are lipid-laden macrophages surrounded by lymphoid cells, histiocytes, and neutrophils; however, mucin deposition is not a typical feature. Herein, we report a rare case of xanthoma with diffuse, abundant mucin deposition.
Xanthomas present clinically as eruptive, tuberoeruptive, tuberous, tendinous, or planar forms. Among these, eruptive xanthoma (EX) is characterized by sudden development of multiple, red-to-yellow papules, each less than 5 mm in diameter, on the extensor surface of the extremities and the buttock area. EX is often associated with severe hypertriglyceridemia, underlying diabetes, obesity, or excessive alcohol intake. Histologically EX is characterized by foamy cells, which are lipid-laden macrophages surrounded by lymphoid cells, histiocytes, and neutrophils; however, mucin deposition is not a typical feature. Herein, we report a rare case of xanthoma with diffuse, abundant mucin deposition.Heparin-induced bullous hemorrhagic dermatosis (HBHD) is an unusual cutaneous adverse reaction to heparin characterized by acute onset of hemorrhagic bullae.
An exuberant case of HBHD is reported, and a revision of previously reported cases indexed on PubMed is provided. Cases were tabulated to the following parameters sex, age, type of heparin and route of administration, associated medical procedure, number of days between heparin start and onset of lesions, site of the lesions, level of blister on histopathology, inflammatory infiltrate on histopathology, direct immunofluorescence findings, heparin-related intervention, number of days to resolution of skin lesions, associated hemorrhagic event, and outcome.
A 21-year-old woman with end-stage renal disease was receiving intravenous unfractioned heparin (UFH) during hemodialysis section for the past 3 months. Four hours after using for the first time an arteriovenous fistula punctured on her right wrist, the patient noticed the onset of vesicles and blpresent in 10 cases. Eosinophils were found within the dermal inflammatory infiltrate in 2 cases, neutrophils in 2, and a mixture of eosinophils and neutrophils in other 2. Direct immunofluorescence was performed in 18 cases, all of them with negative results.
We hypothesize that mechanical trauma, skin fragility, and the anticoagulation effect of heparin might contribute concomitantly to the development of the lesions and speculate that subepidermal blisters in HBHD could be formed by rupture of the floor of a former intraepidermal blister.
We hypothesize that mechanical trauma, skin fragility, and the anticoagulation effect of heparin might contribute concomitantly to the development of the lesions and speculate that subepidermal blisters in HBHD could be formed by rupture of the floor of a former intraepidermal blister.Melanocytic lesions represent a large portion of the workload in many laboratories. Although many melanocytic nevi can be confidently diagnosed based on routine hematoxylin and eosin light microscopy, ancillary testing is often warranted. Various immunohistochemical (IHC) stains are routinely used in the diagnosis of melanocytic lesions. Because melanocytic lesions are frequently encountered in skin specimens, the use of IHC is likely to represent a significant area of resource utilization in dermatopathology laboratories. Our study investigates the rate of IHC utilization in the diagnosis of melanocytic lesions in a high-volume, government-funded, not-for-profit laboratory. Of the 1230 cases of melanocytic lesions investigated, including benign as well as malignant entities, 300 cases involved the utilization of IHC. IHC was used in a larger percentage of melanomas than nevi and in a larger percentage of melanoma in situ cases than invasive melanomas. SOX10 was overwhelmingly the most frequently used IHC.
Melanocytic lesions represent a large portion of the workload in many laboratories. Although many melanocytic nevi can be confidently diagnosed based on routine hematoxylin and eosin light microscopy, ancillary testing is often warranted. Various immunohistochemical (IHC) stains are routinely used in the diagnosis of melanocytic lesions. Because melanocytic lesions are frequently encountered in skin specimens, the use of IHC is likely to represent a significant area of resource utilization in dermatopathology laboratories. Our study investigates the rate of IHC utilization in the diagnosis of melanocytic lesions in a high-volume, government-funded, not-for-profit laboratory. Of the 1230 cases of melanocytic lesions investigated, including benign as well as malignant entities, 300 cases involved the utilization of IHC. IHC was used in a larger percentage of melanomas than nevi and in a larger percentage of melanoma in situ cases than invasive melanomas. SOX10 was overwhelmingly the most frequently used IHC.